Saddle Up: Anticoagulation for Extracorporeal Membrane Oxygenation in a Pulmonary Embolism and Ischemic Stroke-A Case Report
This case describes an anticoagulation strategy in a postpartum patient on venoarterial extracorporeal membrane oxygenation (VA ECMO) for a pulmonary embolism (PE) with a concurrent ischemic stroke. After receiving systemic lysis, the patient had impending cardiovascular collapse, right heart strain...
Saved in:
Published in | A&A practice Vol. 14; no. 10; p. e01277 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.08.2020
|
Online Access | Get more information |
Cover
Loading…
Summary: | This case describes an anticoagulation strategy in a postpartum patient on venoarterial extracorporeal membrane oxygenation (VA ECMO) for a pulmonary embolism (PE) with a concurrent ischemic stroke. After receiving systemic lysis, the patient had impending cardiovascular collapse, right heart strain, worsening clinical picture, prompting VA ECMO cannulation and subsequent cautious management of the patient's anticoagulation. There have been no similar cases published describing an ECMO anticoagulation strategy and management for this complex clinical situation. By withholding a heparin bolus and delaying initiation of a heparin drip for 24 hours, thromboelastogram (TEG) R-time and partial thromboplastin time (PTT) could be closely monitored while the patient began to recover. |
---|---|
ISSN: | 2575-3126 |
DOI: | 10.1213/XAA.0000000000001277 |